title: Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels.
abstract: The objective of the study was the comparison of anti-Müllerian hormone (AMH) levels among obese or overweight and normal-weight women with the four different polycystic ovary syndrome (PCOS) phenotypes and healthy control subjects. AMH levels were evaluated in four age- and body mass index (BMI)-matched groups of 25 normal-weight and 25 obese or overweight women each, belonging to the four main subsets of the syndrome resulting from combinations of the three diagnostic criteria [group 1: oligo- and/or anovulation (ANOV), hyperandrogenemia (HA), and polycystic ovaries (PCO) on ultrasonographic evaluation; group 2: ANOV and HA; group 3: HA and PCO, group 4: ANOV and PCO], and in 50 (25 obese or overweight and 25 normal weight) age- and BMI-matched healthy control subjects. Age, BMI, waist circumference, FSH, LH, prolactin, testosterone, Delta(4)-androstenedione, dehydroepiandrosterone-sulfate, 17alpha-OH-progesterone, fasting insulin, glucose, AMH, free androgen index, and homeostasis model assessment for insulin resistance index were analyzed. AMH levels were significantly higher in PCOS groups 1 and 2 compared with groups 3 and 4 and the control group and higher in PCOS groups 3 and 4 compared with the control group. AMH levels were significantly increased in normal-weight compared with obese and overweight women. AMH concentrations were independently predicted, in order of significance, by LH and testosterone levels, BMI (negatively), and the total number of follicles 2-9 mm in diameter. The differences in circulating AMH levels between the main phenotypic groups of PCOS women appear to reflect the severity of the syndrome, but are negatively affected by obesity. Increased LH levels might be the most significant independent link between PCOS-associated disorders of ovulation and the observed increase in circulating AMH concentration.
authors.affiliation: Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Piouka
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Farmakiotis
authors.forename: Ilias
authors.initials: I
authors.lastname: Katsikis
authors.forename: Djuro
authors.initials: D
authors.lastname: Macut
authors.forename: Spiros
authors.initials: S
authors.lastname: Gerou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Panidis
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D048429:Cell Size; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006080:Ovarian Follicle / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone